Let the Craziness Begin!

I'm getting my bags packed for my first interview which is on Wed/Thursday in Houston, TX. I am definitely nervous for the interviews but also very excited. I get to have dinner at the home of the Chairman for the Department of Surgery at one of the Houston programs. It should be a memorable experience.

In addition my college roommate lives in Houston so it will be fun to spend a few days with her. We get to watch the much anticipated Colts vs. Patriots game together (we're big Colts fans) and the season premiere of The Amazing Race (we actually sent in a video to audition for the show together while in college). It will be fun to see where she lives and if I could picture myself living in Houston in a few months.

After this trip I will be in Louisville, KY for the medical missions conference with some classmates. I'm sure I will have much to say about that afterwards. Then I have interviews in Kentucky, Minnesota, Ohio, Illinois, Arizona (twice), Texas (twice), Massachusetts, South Carolina, Michigan, Indiana, and likely several other states as I continue to hear from programs. This would be a dream for someone who likes organizing and orchestrating schedules, but it just makes me feel the need to breathe into a paper bag when I try and comprehend this. It is going to be CRAZY (fun, expensive, exhausting, memorable)!! The goal is to have some fun in every city to avoid going crazy. Some plans that I am excited about:

• Camping at the Grand Canyon!!! It will be freezing but a beautiful and memorable way to spend New Year's Eve with a great friend or two
  
• Seeing family in Minnesota
• I've never been to Boston and am excited to spend a few days seeing the sights and attempting to pick up their accent
• In South Carolina hopefully seeing a family that I met while at Taylor that gave me hope that maybe I could handle having children someday... they are wonderful and so fun!
• A few days by myself in Phoenix to explore the area and see if Arizona could be a good fit for me- maybe participate in El Tour de Tucson- 109 mile bike ride conveniently the day after an interview in Arizona with an estimated 10,000-11,000 road bikers.
  

House Church

For the past 15 months or so I have been a part of a small group here in Indy through Common Ground Christian Church that has been a really great experience. The leaders of our group are Arch and Connie. Arch is the pastor of discipleship at Common Ground (and a ridiculously good racquetball player) and Connie is one of the coolest women I know. They are an incredible couple and have chosen to intentionally live in a rougher neighborhood to share life with those individuals. Every Thursday night we spend the evening at their home eating wonderful food that Connie prepares and doing life together. People come with very different perspectives and it has been truly eye-opening to hear each other's insight into a myriad of subjects.

In addition to meaningful conversation on Thursday nights we do some fun activities. Some of us have gone to the drive-in movies, the Indiana State Fair, Ritter's, the lake, countless meals at various restaurants, and much more.

I am so thankful for the opportunity to be a part of this group! Here's to many more fun times to come!

Ironman 70.3

I have caught the Ironman bug and think I have found my venue. If everything goes according to my brilliant plan my college roommate Heather and I will fly to St. Croix in the Caribbean for the half ironman on May 4th,2008.

The race would be a 1.24 mile swim in the Caribbean Sea, a 56 mile bike ride with a hill called "The Beast", and then a half marathon 13.1 mile run. The course looks beautiful so if nothing else we could enjoy the views while our bodies scream at us.

It is one of the Ironman world championship qualifying events for Kona, Hawaii. I have no delusions of qualifying, but it should be incredible to be on the same course as some of the world's best triathletes!

We would have a couple of days before the race to acclimate to the area, do the race, and then enjoy the Caribbean for a few days before flying back to officially graduate from med school. Then I would have a couple of days to pack for Israel. Maybe it's a bit much since I will be trying to secure housing and move to some undetermined location at the same time. You only live once right?

The only triathlon I have done was an Olympic distance which was roughly half the distance this would be. It was pretty miserable at the time, but I am in much better shape physically and mentally.

We're still in the "let's think about it" phase, but I hope it works out. This is probably my last chance to train to this level for at least a few years if ever. Not only would it be an incredible adventure with the accomplishment of a major physical feat, but it would be a fun trip with Heather!

In a Pit With a Lion On a Snowy Day

“When did we start to think goodness is the absence of badness? You can do nothing wrong and still do nothing right.” -Mark Batterson

Mark Batterson is the pastor of National Community Church in the Washington DC area. Last year the book, "In a Pit With a Lion On a Snowy Day" came out and has helped draw attention to the incredible ministry NCC has in DC. I haven't read the book yet, but I have listened to some of his podcasts and he has challenged me to reach for more and not settle.

This quote is helping me get out of my seat and find ways to be a blessing to others. My goal for the next two days is to make these amazing (well the one someone else made was, the jury is still out on mine) chocolate chip cookie pies for my neighbors. For too long I have simply not been a bad neighbor, but I want to be a good one.

He has a blog that is fun and insightful to read. Their church also has a podcast you can subscribe to that I would highly recommend. You can also check out some resources at chasethelion.com.

My Mom

Today is my mom's birthday and in honor of her I wanted to post some of my favorite memories with her. My mom can be ridiculously adventurous and as a result we have shared some unique experiences.

1. London- in college we went to London with Sarah Kolasa (now Bouma) and her mom. We had a blast together touring and goofing off.
   
2. Girl Scouts- my mom was our troop leader and so I got to spend lots of time with both my mom and friends together experiencing new things.
   
3. Sporting events- my parents were always there for the games and practices... mom even served as my catcher for a time when I was learning fastpitch softball.
   
4. Ikea- During college I decided my dorm room was missing a couch and I saw just what I wanted at IKEA in their "as is" section for $20. Unfortunately we had traveled to Chicago in my mom's very small VW beetle. After a little pondering we figured we could work it out so we drove all the way to South Bend with a couch hanging out of the trunk. It was hilarious and such a blast! Plus, the couch served me and my friends well and is probably still being put to good use at Taylor.
   
5. Cozumel, Mexico- After graduating from Taylor mom and I took a trip to Cabo san Lucas and goofed off for a week. We went 4 wheeling on the beaches, learned how to stay alive on a sailboat (I can't say we could "drive" it too well, but we had fun and no permanent injuries were incurred), and just had a fun week together.
6. Calling my parents to inform them that I was accepted into medical school- there is no one I would rather share my successes with!
7. Long conversations at Lula's, our typical hang-out location
8. Multiple family vacations to Puerto Vallarta and Colorado, yes my mom not only participated in the "zipline adventure" in Mexico, but she was the one who insisted on it. You should see her on a boogie-board! In Breckenridge I convinced her to come down a black diamond slope with me, and while no bones were broken, the ski patrol were involved and my mom got to ride a sled down the mountain.
9. Meeting President George W. Bush together- my dad scored some great seats for us and mom and I had no shame in fighting our way in to meet him.
10. Driving around South Bend right after we had bought my first manual transmission car. I think we are all a few IQ points down due to the whiplash we experienced that day. The best was when a man who saw the stickers still on the car and my repeated failed efforts to reverse out of a parking space told me "If you haven't bought it yet, I wouldn't!" I think we laughed so hard we cried, or at least I wanted everyone to think they were tears of laughter.
    

I love knowing that the best is yet to come. We're heading to Israel for 2 weeks in May to tour with Kay Arthur and crew which should be pretty amazing!

To Write Love On Her Arms

I met a patient last night that will stick with me for a long time. It was a young adolescent who came in with an overdose. As I went to introduce myself I was struck by the lost and absent look in her eyes. I had recently heard of an organization called "To Write Love On Her Arms" that is dedicated to helping girls who are into cutting and other harmful behaviors. With that organization on my mind I did a more thorough physical exam than I normally would. I found ice burns on her back and evidence of recent cutting on her wrists. I spent a little time talking with her trying to understand why she took the pills, why she cuts herself and does other self-injurious behavior. She gave me no reason, but made it clear that she is lost and confused and living in a fog.

After ordering some tests and seeing other patients I went back to check on her and had probably the most terrifying experience of medicine so far. Her family was sitting by the bed while she was sleeping. I tried to wake her to get her attention and she wouldn't budge. I began talking louder and shaking her and still nothing. I literally thought she was dead and I was about to try and call a code in front of her family. In reality she was hooked up to monitors and we would have been alerted to any changes in her vital signs, but that didn't occur to me in the heat of the moment. Thankfully she aroused and was ok. Needless to say, I checked up on her often for the rest of the night.

As Don Miller says we're called to hold our hands against the wounds of a broken world, to stop the bleeding.

The story of this organization is very compelling and I plan on continuing to support them financially, through word of mouth, and through referring teens who need help to them. They toured recently with Anberlin and are now touring with Bayside, June, The Sleeping, and A Day to Remember. They will be at the House of Blues in Chicago on Nov 29, Cincinnati on Nov 30, and then Detroit and Cleveland.

Their website says, "We often ask God to show up. We pray prayers of rescue. Perhaps God would ask us to be that rescue, to be His body, to move for things that matter. He is not invisible when we come alive. I might be simple but more and more, I believe God works in love, speaks in love, is revealed in our love. I have seen that this week and honestly, it has been simple: Take a broken girl, treat her like a famous princess, give her the best seats in the house. Buy her coffee and cigarettes for the coming down, books and bathroom things for the days ahead. Tell her something true when all she's known are lies. Tell her God loves her. Tell her about forgiveness, the possibility of freedom, tell her she was made to dance in white dresses. All these things are true.


We are only asked to love, to offer hope to the many hopeless. We don't get to choose all the endings, but we are asked to play the rescuers. We won't solve all mysteries and our hearts will certainly break in such a vulnerable life, but it is the best way. We were made to be lovers bold in broken places, pouring ourselves out again and again until we're called home."

Quote of the Week

So most close friends of mine know that I love quotes. I have tons stored on my computer, posted all over, made into artwork (by my wonderful friend Tara who is a fantastic artist- she also does the coffee shop board at GCC), etc .... So periodically I will indulge myself and post some quotes of great significance to me. Here goes...

"We must know God before we can love Him. To know God, we must often think of Him. And when we come to love Him, we will think of Him often, for our heart will be with our treasure." -Brother Lawrence


This quote is from Brother Lawrence's book, The Practice of the Presence of God, which revolutionized my thinking on how we are to go about our daily lives. As Rob Bell said the term "spiritual-life" would have been a foreign concept to the people in the times of the Bible. There were no divisions in life and there aren't meant to be any. As I began to think of creative ways to cue my mind to thoughts of God throughout the day, I was amazed at the difference it made in my attitude and perspective on life. I still have lots of room to grow, but I am more convinced that this is how life is to be lived.

If you haven't read this book I would encourage you to. It's a fairly quick read and definitely worth the time!

Sprint then rest...

I've worked 53 of the last 79 hours in the emergency department and now I have nearly 48 hours off before I work the night shift. As some wise people at GCC say "Sprint, then rest...sprint, then rest...". I couldn't agree more. I love to work hard and also to play hard. Here are my plans:

• sleep
  
• swim practice
• read (hopefully from my hammock on my patio as pictured here with a beautiful view of the city) - Pathologies of Power by Paul Farmer- this is a pretty heavy book by one of the men in medicine that I respect the most, but right up my alley as it discusses the health care crisis around the world. This brilliant man is making a huge difference in Haiti and around the world as he uses his influence and gifts to bring health care to those who need it most.
  
• watch 24 on my wonderful lovesac seriously if you've never sat in one you really need to- I'm on Season 5 and pretty hooked. I find myself walking through the hospitals wondering if people are terrorists or working for the CTU and if nerve gas has been released.
• attend a helpful lecture at the med school on buying a home. I'm not sure if I will be able to buy one in a few months- it kind of depends on where I end up, but a conversation with my parents recently highlighted how naive I am about the whole process. I'm so glad my parents are wise and able to explain to me the many realities of life that I know essentially nothing about. But I can draw the citric acid cycle for you...
• Clean- my apartment is clean by my standards but on Friday my good friend whose name rhymes with Sara Six (pictured below) is coming and she cleans with toothpicks.
• Try and spend time getting to know my new neighbors. I met them today for the first time and really would like to build a friendship with them.
  
• Grey's Anatomy!

Lactic Acid

I just returned from Day one of the Hilly Hundred. We did 47+ miles with a total climb of well over 3000 feet. My maximum heart rate was a measly 202 beats/minute on a beta blocker nonetheless. My heart rate monitor estimated I burned 2200+ calories, while Matt's which is more accurate estimated 3600. That's ridiculous. I am exhausted!

It was definitely tricky to plan apparel for the ride since the temperature was in the 30s when we arrived and reached the mid 60s. Overall it was a beautiful day and now that it is over I can say that it was a good one.

The low point in the day was this man I kept finding myself near who had speakers rigged up to his bike playing classical music. Who does that? At least play some peppy music that will make people want to press on, not sit down and read a good novel.







Because I'm crazy (and the Colts have a bye week) I'm going out again tomorrow. Apparently Sunday is much harder and based on the images there are some ridiculously steep climbs. The good news is that I have nothing to prove and will swallow my pride and walk if necessary.

19 days

So my first official interview for residency is in 19 days and that is a crazy thought! I will intentionally stay vague about where I am interviewing and my thoughts on the programs in case someone is so interested in me that they just have to search for my blog to see what I really thought of them. Not likely, but I've invested enough at this point to not risk that.
I had a mock interview yesterday with a cardiothoracic surgeon which went fairly well. Here are a few thoughts:
1. I need better black trouser socks.
2. I'm glad I bought a second suit.
3.. I need to prepare better for politically incorrect questions- I should have seen that one coming with surgeons.
4. I need to learn more about the future of both general surgery and pediatric cardiothoracic surgery. I did fairly well on these questions, but there is definite room for improvement.
5. This process is going to be a blast! While the thought of traveling all over the country for 3 months sounds daunting and exhausting, I will get to meet with some of the superstars of the surgery world both in their offices and homes. I will also get to see many friends and family members that I don't see often enough.

Live in Your Strengths

"Not trying to be everything is smart. Not working on everything but rather emphasizing the development of selected powerful talents is the route to excellence. " Donald Clifton

I recently finished the Strengthsfinder 2.0 book and survey and have been trying to figure out what my next step needs to be. Here are my top 5 strengths:

1. Learner-not too surprising given my current role as a professional student/test-taker. I'll never forget when one of my attending physicians said to me, "You're just intolerant of ignorance." I had never thought about it, but it makes sense. I'm intolerant of both my own and other people's ignorance. I want to understand every detail of a situation and I want to be able to educate those around me. I thrive on learning new things- road biking, swimming...

2. Achiever- shocking right? I wonder how many med students would have this on their list. I tend to feel fulfilled when I accomplish goals. This explains why I have hated certain rotations recently where I feel like I accomplish nothing or contribute very little to the team and I love rotations where I have autonomy and can work as hard as I would like to.

3. Command- This one has been tempered in the past few years as I have been the low man on the totem pole, but just wait until they give me authority. Just kidding.... I must admit there are situations where I see a lack of command or leadership and it drives me crazy! Leadership is influence, not position and I look forward to developing this skill.

4. Futuristic-I'm the kid who was telling everyone in high school what I was going to do with the rest of my life and the impact I hoped to have. I guess that counts. My visions and dreams have expanded since then, but I never want to stop dreaming. As Henry David Thoreau said, "In the long run we hit only what we aim at."

5. Maximizer- "Excellence, not average, is your measure." While I wish this were true of me more often, I am growing in this one. As individuals at GCC say often, "Excellence honors God and inspires people."

I would highly recommend this book and the survey to anyone. I think it is essential to know your strengths, develop them, and do something with them. It has been fun discussing this with my House Church in Indy and other friends. Imagine what the world could look like if everyone lived in their strengths!

Taylor Friends

I had Friday evening off and was able to get together with some of my friends from Taylor University.

In college we regularly went to Texas Roadhouse and had contests eating the rolls (they are amazing and they give you cinnamon butter with them!) So of course we had to go back although we limited our roll consumption a little bit.

After dinner we played several hours of intense but friendly games. Our college classic game was Speed Scrabble. It is ridiculously fun. We also played The Amazing Race DVD game which was pretty fun although the machine tried to sabotage my team's quest for domination. We also played Pit and Dutch Blitz. Pit is a good game because it rewards me for being loud and obnoxious.

It is such a blessing to graduate from college with a group of great friends to share life with.

Why I Love Medicine

I have worked a ridiculous number of hours in the Emergency Department in the past 4 days and yet I am full of energy because I love what I am doing! Here are some of the highlights:

• I got to spend over an hour with a young adolescent who needed his whole hand stitched up because he couldn't control his anger in a fight with his mom. I had his attention (thanks to large needles) for over an hour when I could talk with him and try and convey that his life can have meaning far beyond drugs and alcohol. In the room with him (at this point I was in the jail area of the hospital) were two early high school students who were even more confused. Where else can you truly have the attention of kids like this? I love my job! By the way, the stitches turned out well.
  
• Also of note, I got to hold a very sick patients hand while trying to explain what was happening to her. It was clear that more than anything she just wanted someone to hold her hand so she wasn't going through this alone. Of course I tended to her medical needs, but sometimes the human interaction is what patients really seek.
  
• I saw a young man with the dreaded flesh-eating bacteria who had already had emergency surgery and amputation of part of his hand. I have never seen an arm so mutilated. Now he was back because he was couldn't afford the antibiotics that he needed. There really is something wrong with our health care system. I wish I knew what could help people like this so that their outcomes could be more like Paula Abdul's (didn't she have this during a season of American Idol after a manicure?).
  
• As I was walking to my car at 1:30 am I came upon a man trying to get a woman to the ER and she was sobbing and falling over and trying to run in front of cars. My classmate and I insisted on helping even though the man clearly was not interested in our help (1 in 4 women in the ER are being abused) and I ran and got a wheelchair and we safely took her to the ER. We weren't able to figure out what was going on, but it obviously wasn't a good situation and I was glad to ensure that she received help.
  

So while these are only a few of the many patients I have seen, I feel so privileged to be a part of the doctor-patient relationship. It is an incredible ministry and I couldn't imagine doing anything else.

Better

I am a big fan of Atul Gawande, a surgeon at Brigham and Women's Hospital (one of the premier hospitals in this country). In this book he discussed how we can work to make healthcare better. It was a very compelling read for me as I consider what I need to do to move towards excellence in the way I care for patients and their families. Some of his supporting stories included:

• the significant strides that have been taking in infection control since they learned that the washing of hands by workers in the hospital fights infection
  
• the widespread and awe-inspiring immunization efforts taken in recent years with outbreaks of polio in different villages in India to prevent further spread
  
• the vast improvement military physicians have made in their treatment to help save the lives of soldiers in Iraq- it is incredible how they build mobile hospital units that bring the help to the frontlines and save the lives of many who would not have made it in prior wars
  
• The morality of physicians overseeing executions was also an interesting section
• The grand finale was a discussion on the bellcurve that exists in physicians performance that reaffirmed what I have observed in medicine in a short period of time. I want to work to become a positive deviant.

5 suggestions to become a positive deviant by Atul Gawande

1. Ask an unscripted question- learn something about them such as “where did you grow up?” “did you watch the game last night?” etc…
1. “If you ask a question, the machine begins to feel less like a machine.”
2. Don’t complain- it is infectious and leaves people feeling angry and sorry for themselves. It’s boring, it doesn’t solve anything, and it will get you down. You don’t have to be sunny about everything. Just be prepared with something else to discuss: an idea you read about, an interesting problem you came across.
3. Count something- Count the number of patients who develop a certain complication… if you count something you find interesting, you will learn something interesting
4. Write something- a blog, paper for a professional journal, a poem…. It need only add some small observation about your world. You should not underestimate the effect of your contribution, however modest. You should also not underestimate the power of the act of writing itself. ( I guess this helped convince me to start a blog)
   
5. Change- make yourself an early adopter. Look for the opportunity to change. Be willing to recognize the inadequacies in what you do and to seek out solutions.

Fitness Fun

I took a new spinning class yesterday and ended up being the only person there. It was pretty weird having a one-on-one spinning session with a man who kept barking and asking me random math questions that in some way impacted our workout (ie. what is 30 percent of 80 rpm?). It was all very odd although I did get a great workout.

Today I joined the Indy SwimFit- a masters level swim team. Our practice was at the IU Natatorium which I had never swam in before. It was an incredible workout. I did twice the distance I normally do and at a much faster pace. I am excited to continue to work on my strokes and strength.

Someone needs to talk me out of it because I am feeling the urge to do an Ironman triathlon. The only option for next year would the August one in Louisville since all the other registrations are full. The $475 registration fee doesn't make me feel any better about the prospect of likely 12+ hours of torture. It probably wouldn't be a realistic goal during my internship and lets be honest, it's the last thing my body or anyone's really needs to endure. But what a feat it would be! Maybe while I do a year or two of research in residency I can find someone to train with and give this a little more thought.

Road Biking

This is my new bike. I believe it is my favorite possession right now.

I was terrified of the idea of having my feet clipped into the pedals, but I will never go back now that I am used to it. I have yet to fall, but just give me a few more weeks and I just might have my first real broken bone.

I am participating in the Hilly Hundred in less than two weeks so this bike should get some serious miles then. In the meantime I am trying to find some hills to help get me in shape for the upcoming torture/ great workout.

Last year Heather, my college roommate, and I completed the first 50 miles and then decided that life is too short and we don't get to see each other often enough to justify another 50 miles of huffing and puffing (especially with a Colts game as the other option).

This year I am riding with my friend Matt who is a cycling enthusiast. We rode the Nite Ride together this summer which I would highly recommend. This should be a little more strenuous so we'll see how it goes.